Microbiology

Question 1

Which is the best specimen to send to the microbiology lab to screen for sexually transmitted infections in a 20 year old asymptomatic female who attends her GP Practice?

Answer 1

A vulvovaginal swab for chlamydia/gonococcal PCR

Question 2

What is the treatment of bacterial vaginosis?

Answer 2

Metronidazole

Question 3

What is the treatment of trichomons vaginalis

Answer 3

Metronidazole

Question 4

What serotypes of chlamydia are associated with Lymphogranuloma Venereum
infection in MSM?

Answer 4

L1,L2 & L3

Question 5

Which genital infection

is indicated by the presence of “Clue cells”

Answer 5

Bacterial vaginosis

Question 6

Which STI requires a test of cure

Answer 6

Gonorrhoea

Question 7

What is the scientific name for syphilis?

Answer 7

Treponema pallidum

Question 8

What is the gram stain of neisseria gonorrhoeae?

Answer 8

Gram negative intracellular diplococcus (2 kidney beans facing each other)

Question 9

How does pharyngeal gonorrhoea present?

Answer 9

Mainly asymptomatic

Question 10

How does genital gonorrhea present in men/women?

Answer 10

Men - discharge (can be green) / pain / painful urination

Women - altered discharge / dysuria / pelvic pain

Question 11

What is the treatment of gonorrhea

Answer 11

IM ceftriaxone (must be done in sexual health clinic not community)

Question 12

What antibiotic are coliforms sensitive to?

Answer 12

Gentamicin

Question 13

What bacteria does amoxicillin treat?

Answer 13

Gram positive bacteria

Question 14

What antibiotic are anaerobes sensitive to?

Answer 14

Metronidazole

Question 15

What is diagnostic of septic shock?

Answer 15

Low blood pressure that does not come back up when IV fluids are given

Question 16

What is a side effect of gentamicin?

Answer 16

Dizziness

Question 17

What organism causes meningitis in >21s

Answer 17

Strep pneumoniae (gram +ve diplococcus)

Question 18

What organism causes meningitis in 10-21s

Answer 18

Neisseria meningitidis (gram negative intracellular)

Question 19

What organism causes meningitis in children?

Answer 19

Haemophilus influenzae (gram negative bacillus)

Question 20

What age groups are susceptible to meningitis caused by listeria

Answer 20

> 60 years or immunocompromised or neonates

Question 21

When are steroids given in meningitis?

Answer 21

With or just before the first dose of antibiotics

Question 22

What does high lymphocytes in the CSF indicate?

Answer 22

Often indicates viral meningitis or encephalitis

Question 23

Where can you get listeria from?

Answer 23

Soft cheeses, cured meats and seafood

Question 24

What is the treatment of bacterial meningitis?

Answer 24

Ceftriaxone IV (chloramphenicol for penicillin allergy) + dexamethasone IV

+ amoxicillin (co-trimoxazole for penicillin allergy) in listeria

Question 25

Why is ceftriaxone better than penicillin in meningitis treatment?

Answer 25

It has a longer half-life

Question 26

Do you test for genital herpes in an asymptomatic patient?

Answer 26

No

Question 27

What are the 4 C antibiotics

Answer 27

Clindamycin, cephalosporins (eg ceftriaxone), co-amoxiclav and ciprofloxacin

Question 28

What are the components of sepsis 6?

Answer 28

Give 3 - Give fluids, oxygen and antibiotics

Take 3 - Take blood cultures, monitor urine output and measure lactate

Question 29

If a patient has been on amoxicillin, metronidazole and gentamicin for 3 days and you have found coliforms in the blood culture but have not yet gotten results for sensitivities, what should you do?

Answer 29

Prescribe aztreonam as a substitute for gentamicin as this is day 4

Question 30

Do high lymphocytes in the CSF in a patient with meningitis always indicate the cause is viral meningitis?

Answer 30

No - it could be partially treated bacterial meningitis as the partial treatment interferes with the CSF results

Question 31

When would you inform public health about a case of meningitis?

Answer 31

Within 24hrs of admission